Limiting The Damage With New Equipment, Cooley Dickinson Makes Gains In Minimally Invasive Surgery

With minimally invasive procedures rising to the forefront of modern surgical practice, two new pieces of equipment at Cooley Dickinson Hospital (CDH) position the Northampton institution as a more effective provider of non-traumatic care.
The devices, the Holmium laser and the harmonic scalpel, both allow physicians to perform common urological procedures, such as breaking up kidney stones, treating bladder tumors, and conducting laparoscopic surgery, with less discomfort and easier recovery periods for patients.

“Minimally invasive surgery is really the trend right now,” said Dr. Donald Sonn, a urologist at CDH. “In the future, instead of making large incisions and having the patient stay in the hospital for weeks, with the development of minimally invasive surgery like laparoscopy, patients will achieve the same goals but have quicker recovery times and shorter hospital stays.”

And, as he told The Healthcare News, that reduction in anxiety and pain can be as important to patients as the procedure itself.

The Light Fantastic

The Holmium laser is not new technology, but this is the first time Cooley Dickinson has acquired one.
The device produces tiny bursts of energy that are precisely directed at very specific areas — for instance, to destroy kidney stones, one of its main uses. The laser causes little collateral damage to surrounding tissue and reduces bleeding. Most procedures can be done on an outpatient basis, and virtually all patients can be discharged within a day or two.

“It’s a fairly recent technology which uses a special energy in the form of a laser to break up kidney stones,” Sonn said, adding that other applications include treating soft-tissue lesions, tumors, and scar tissue.

“The nice thing about the laser is that it can be used through very tiny telescopes, and, therefore, it’s a more comfortable procedure for patients. Normally, you have to use other types of energies that can cause collateral damage, but with the laser, you’re able to focus the majority of the energy directly onto the stone, as opposed to surrounding tissues. So it’s considered within the realm of minimally invasive surgery.”

Research shows that the Holmium laser may be used with patients who have cardiac pacemakers, and it also promotes blood coagulation during cutting, keeping bleeding to a minimum. “One nice thing about the laser is that it can be used on patients who have bleeding problems or are on blood thinners,” Sonn added. “They don’t have to be taken off the blood thinner.”

Studies have proven the laser to be virtually 100{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} effective in breaking up kidney stones of all types, where other treatment methods may be effective only around 80{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} of the time. Therefore, the Holmium laser often eliminates the need for other forms of kidney stone treatments.

Cutting Edge

The harmonic scalpel is used primarily to cut through tissue but also to coagulate small vessels, and it was first used at Cooley Dickinson about one year ago.
“It’s another relatively new device that can be used in laparoscopic applications,” Sonn said. “Again, it uses high-frequency energy to cut through tissue, and it also minimizes collateral damage.”

The harmonic scalpel’s advantages over electrosurgery and laser surgery also include less lateral thermal damage. With those procedures, coagulation occurs by excessive heating and charring of the tissue, and cutting occurs by heating the tissue so rapidly that water within cells vaporizes and explodes the cells, according to the Johnson & Johnson company, which manufactures a harmonic scalpel.

The scalpel, on the other hand, cuts and coagulates tissues at lower temperatures than those procedures. Other advantages include minimal smoke, resulting in a clearer visual field for the physician, and no electrical energy passed to or through the patient, meaning there is no risk of electric shock.

“Using high-frequency vibrations to coagulate tissue, rather than standard methods like electrical currents — which are more likely to cause collateral damage — this device can enable the surgeon to perform laparoscopic procedures safely and more effectively for most patients,” Sonn said. “It is important that surrounding communities and physicians know that we can perform this type of state-of-the-art procedure.”